Skip to main content
Post your resume and find your next job on Indeed!

Work From Home Medical Billing jobs

Sort by: -
    • Review, interpret, and summarize plan designs from insurance contracts.
    • Demonstrated knowledge and experience of Group Benefits Prescription Drug plans, with…
    • Availability to work evenings and Saturdays on a rotating schedule.
    • Proven experience in billing, collections, and/or customer service.
    • Experience and knowledge of EHC billing practices, insurance companies, and coverage information.
    • We are seeking a dynamic individual with strong interpersonal…
    • Familiarity with medical terminology is an asset.
    • Perform all work in a PIPEDA and HIPAA compliant manner.
    • Proactive/Takes initiative, able to work with minimal…
    • Execute database scripting and data verification for billing accuracy.
    • Implement and validate rules using the Majesco Rules Engine aligned to billing logic.
    • View all Capgemini jobs - Mississauga jobs - Shift Leader jobs in Mississauga, ON
    • Salary Search: ICD ICM Majesco Billing Lead Configurator salaries in Mississauga, ON
    • See popular questions & answers about Capgemini
    • Experience in medical billing is preferred.
    • Experience with medical billing software and EMR systems is considered an asset.
    • Ensure contract compliance and accurate billing.
    • Ability to collaborate and work autonomously.
    • Accurately capture minutes / actions from meetings.
    • Nous sommes Ubiweb, l'agence de marketing numérique qui connaît la plus forte croissance au Canada.
    • Nous offrons des solutions numériques aux petites et…
    • Self-Starter: Proven ability to work independently and stay organized in a fully remote setting.
    • We are seeking a Group Benefits Claims Adjudicator and Benefits…
    • The Reimbursement Associate will also be assigned other duties and tasks as required from time to time.
    • Reporting to the Manager, the Reimbursement Team Lead…
    • Prendre des décisions éclairées quant au risque et offrir son soutien aux équipes des ventes et du marketing du secteur des Marchés individuels.
  • View similar jobs with this employer
    • Collaborate with in-house return to work facilitators to design and monitor return to work programs.
    • Four weeks annual vacation from hire date.
    • You’ll work closely with an experienced group of professionals, focusing on exceptional client service and operational excellence.
    • Review billing information for accuracy.
    • Resolve rejected claims and outstanding billing issues.
    • Comfortable using billing software and electronic records.
    • Volume varies based on specialty and we consistently check in to make sure we are respecting your bandwidth.
    • Contract (payment on per-consult basis).
Get e-mail updates for the latest Work From Home Medical Billing jobs

By creating a job alert, you agree to our Terms . You can change your consent settings at any time by unsubscribing or as detailed in our terms.

People also searched:

medical office
medical office assistant
medical receptionist
ocean freight
part time, remote
work from home, remote
billing analyst
billing clerk
billing coordinator
billing specialist

Career Resources:

Job Post Details

Prescription Drug Claims Specialist - job post

Orion Audit
Kleinburg, ON•Hybrid work
$70,000–$80,000 a year - Full-time

Job details

Pay

  • $70,000–$80,000 a year

Job type

  • Full-time

Location

Kleinburg, ON•Hybrid work

Benefits

Pulled from the full job description

  • Tuition reimbursement
  • Dental care
  • Life insurance
  • Employee assistance program
  • Disability insurance
  • Paid vacation
  • RRSP match

Full job description

WHY THIS ROLE MATTERS:

To conduct high quality and detailed Prescription Drug Claim Audits on behalf of our clients. This includes analyzing Prescription Drug claims data, detecting and evaluating patterns, trends and anomalies, and turning them into meaningful insights and recommendations for our clients through formal written reports and presentations.

A component of this role includes supporting our consulting team as a technical resource. Conducting technical reviews, insights, and recommendations for the Prescription Drug portion of our clients Group Benefits plans. Keeping up with key industry trends, new products, and processes is highly valued.

WHAT YOU’LL BE RESPONSIBLE FOR :

  • Conduct high quality, detailed, Drug claim audits; evaluate adjudication processes, error rate, test plan eligibility and adherence to the insurance contracts
  • Review, interpret, and summarize plan designs from insurance contracts
  • Analyze drug claim data, and effectively detect and evaluate patterns, trends and anomalies
  • Identify opportunities, solutions, and recommendations to improve claims administrative processes with a focus on cost savings and risk management
  • Prepare written reports; technical writing outlining observations and findings of claim audits
  • Participate in the preparation and presentation of audit insights, findings, and recommendations:
  • to current or prospective clients; and
  • to generate new business opportunities

WHAT YOU BRING TO THE ROLE:

  • Demonstrated knowledge and experience of Group Benefits Prescription Drug plans, with experience in retail or hospital pharmacy, pharmacy operations, drug claim billing expertise, or insurance industry
  • Five to ten years of experience in processing practices of drug claims for Group Benefit plans at a TPA, PBM and/or insurance company, and claims processing in a pharmacy setting
  • Knowledge of Provincial Pharmacare Programs; including both private and public reimbursement models
  • Solid background and familiarity with: Industry best practices, Coordination of benefits, Internal audit processes and fraud detection, Prescription Drug plan design, Drug Utilization Reviews, Drug pricing and fee structure, Brand and generic drugs, Narcotic controls.
  • Strong communicator and presenter, able to manage multiple priorities in a fast-paced, fluctuating environment with strong written and verbal skills.
  • Analytical and tech-proficient, with strong research, problem-solving, and decision-making skills, and proficiency in Word, Excel, and Outlook.

Assets

  • Recent retail, commercial, or hospital pharmacy adjudication/processing experience is strongly preferred
  • Experience in adjudicating Extended Health and prescription Drug claims at an insurer or TPA or PBM
  • Experience with Pharmacy Benefits Management, drug plan design, or drug reimbursement models
  • Experience in Group Benefits risk management, including fraud detection and prevention strategies

WHAT WE OFFER:

  • Health and Dental Benefits
  • RRSP Match Program
  • Hybrid Work Environment
  • Paid Vacation Time
  • Educational Reimbursement
  • Expense Reimbursement

This is for an existing position.

Navacord DOES NOT utilize artificial intelligence in the screening, assessment, or selection of applicants for this position.

Navacord is actively committed to support diversity, equity, and inclusion. We serve and recognize and respect human differences and similarities. We value the diversity of people and actively encourage women, indigenous peoples, members of visible minorities, people with disabilities, and lesbian, gay, bisexual, transgender, and queer (LGBTQ2+) persons to apply. We are committed to providing accommodation upon request for applicants and employees with disabilities. If you require accommodation, we will work with you to meet your needs.

Pay: $70,000.00-$80,000.00 per year

Benefits:

  • Dental care
  • Disability insurance
  • Employee assistance program
  • Extended health care
  • Life insurance
  • RRSP match
  • Work from home

Work Location: Hybrid remote in Kleinburg, ON

Let Employers Find YouUpload Your Resume